Symptom persistence and biomarkers in post-COVID-19/chronic fatigue syndrome – results from a prospective observational cohort

Legler, Anna Franziska; Meyer-Arndt, Lil; Moedl, L; Kedor, Claudia; Freitag, Helma; Steinle, Elena; Hoppmann, Uta; Rust, Rebekka; Konietschke, Frank; Thiel, Andreas; Paul, Friedemann; Scheibenbogen, Carmen; Bellmann‐Strobl, Judith

doi:10.1101/2023.04.15.23288582

Cited by 6 publications

(3 citation statements)

References 43 publications

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“…However, while the disease mechanisms and predisposing factors remain to be elucidated, deep phenotyping of patients with particularly severe long term health impairments has shown that a subset of these patients fulfil criteria of myalgic encephalomyelitis or chronic fatigue syndrome (known as ME or CFS) and have a particularly poor chance for long term recovery. 54 55 …”

Section: Discussionmentioning

confidence: 99%

Post-covid-19 conditions in adults: systematic review and meta-analysis of health outcomes in controlled studies

Franco,

Garegnani,

Metzendorf

et al. 2024

bmjmed

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ObjectiveTo assess the impact of post-covid-19 conditions among adults.DesignSystematic review and meta-analysis of health outcomes in controlled studies.Data sourcesTwo sources were searched from database inception to 20 October 2022: Cochrane covid‐19 study register (comprising Cochrane Central Register of Controlled Trials, Medline, Embase, clinicalTrials.gov, World Health Organization's International Clinical Trials Registry Platform, medRxiv) and WHO's covid-19 research database.Eligibility criteriaCohort studies recruiting more than 100 participants with a control group and a follow-up of at least 12 weeks were included. Adults who were documented to have SARS-CoV-2 infection based on clinical, imaging, or laboratory criteria were included.Data extraction and synthesisTwo independent reviewers extracted data. The main outcomes included quality of life, functionality in daily activities, use of resources, recovery rates (cluster of symptoms), and the incidence of new medical diagnoses. Data were pooled using a random effects model. The risk of bias was assessed with the Joanna Briggs Institute critical appraisal tool for cohort studies.ResultsWe included 63 controlled cohort studies, encompassing more than 96 million participants. Based on five studies, we found a reduction in overall quality of life between individuals with confirmed SARS-CoV-2 infection versus controls at six to 24 months follow-up, although heterogeneity was very high (mean difference in EQ-5D scale −5.28 (95% confidence interval −7.88 to 2.68; I2=93.81%). Evidence from ten studies, which could not be pooled in a meta-analysis, indicated that an increased rate of functional impairment associated with SARS-CoV-2 infection. Use of care increased compared with controls at six to 24 months follow-up at intensive care units (risk ratio 2.00 (95% confidence interval 0.69 to 5.80), five studies, I2=91.96%) and in outpatient care (1.12 (1.01 to 1.24), seven studies, I2=99.51%). Regarding persistent symptoms, individuals with documented SARS-CoV-2 infection had an increased risk of having two or more persistent symptoms at follow-up, especially those related to neurological clusters (ie, risk ratio 1.51 (95% confidence interval 1.17 to 1.93), I2=98.91%). Evidence also showed an increased incidence of a wide variety of metabolic, cardiovascular, neurological, respiratory, haematological and other incident diagnoses.ConclusionEvidence suggests functional impairment after SARS-CoV-2 infection, in addition to a higher use of resources and a higher incidence of widely varying medical diagnoses. These results should be interpreted with caution, considering the high heterogeneity across studies and study limitations related to outcome measurement and attrition of participants.Systematic review registrationOpen Science Framework,osf.io/drm39

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Section: Discussionmentioning

confidence: 99%

Post-covid-19 conditions in adults: systematic review and meta-analysis of health outcomes in controlled studies

Franco,

Garegnani,

Metzendorf

et al. 2024

bmjmed

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“…Os autores desse estudo constataram que os pacientes com covid longa e ME/CSF apresentavam sintomas mais graves, e poucos deles mostraram melhora após 18 meses. Eles concluíram que o diagnóstico de ME/CSF em pacientes com covid longa ajuda a identificar aqueles que têm Covid longa, a pandemia que não terminou um prognóstico mais grave e precisam de tratamento e suporte mais intensivos (Legler et al, 2023). 29 Finalmente, alguns especialistas propuseram que a controvérsia sobre se a covid longa é uma "doença real" (ou seja, de origem orgânica) ou um transtorno "imaginário" (de natureza não orgânica) sem uma causa discernível é uma discussão infrutífera.…”

Section: A Difícil Busca Por Dados Epidemiológicos Confiáveisunclassified

Covid longa, a pandemia que não terminou

Segata,

Löwy

2024

Horiz. antropol.

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Resumo O artigo explora a complexidade e as incertezas atuais sobre a covid longa, uma entidade nosológica emergente pós-covid-19, com contornos imprecisos e caracterizada por sintomas imprevisíveis e persistentes. Baseado em relatos de pessoas afetadas e equilibrando a revisão da literatura médica e jornalística sobre o tema, a história da ciência e a etnografia em saúde, o trabalho descreve e analisa as políticas de reconhecimento e de cuidado da doença em um contexto de injustiça epistêmica. O artigo contesta as representações da covid longa como uma condição meramente transitória, argumentando que, diferentemente das promessas de plena recuperação, o que tem ganhado forma é emergência de uma nova pessoa cuja biografia passa a ser reescrita com a covid longa. Para essas pessoas, o reconhecimento pleno da covid longa como uma entidade patológica distinta, aliado à validação de seu conhecimento experimental, significa mais do que simplesmente abrir possibilidades concretas para alívio do sofrimento físico e mental. Isso também representa justiça, reparação e um passo adiante na reconstrução de suas vidas.

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“…The authors of this study observed that patients with long COVID and ME/ CSF presented more severe symptoms, and few of them showed improvement after 18 months. They concluded that diagnosing ME/CSF in patients with long COVID helps identify those who present a more severe prognosis and require more intensive treatment and support (Legler et al, 2023). 26 Finally, some experts have proposed that the controversy over whether long COVID is a 'real disease' (i.e.…”

Section: A 'Real Disease' or A Functional Disorder?mentioning

confidence: 99%

Long COVID, the unending pandemic

Segata,

Löwy

2024

Horiz. antropol.

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The article explores the complexity and current uncertainties concerning long COVID, an emerging nosological entity with vague contours and characterised by unpredictable and persistent symptoms and absence of ‘objective diagnosis’. Based on accounts of the affected individuals and balancing the review of medical and journalistic literature on the subject, historical approach and ethnography, this work describes and analyses the policies of recognition and care of this condition in a context of epistemic injustice. The article contests the representations of long COVID as a merely transient disorder arguing that, unlike the promises of full recovery, what is taking shape is the emergence of a new individual whose biography is being rewritten by long COVID. For these people, full recognition of long COVID as a distinct pathological entity, coupled with the validation of their experimental knowledge, means more than merely opening concrete possibilities for relief from physical and mental suffering. It also represents justice, repair, and a further step towards the reconstruction of their lives.

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Symptom persistence and biomarkers in post-COVID-19/chronic fatigue syndrome – results from a prospective observational cohort

Cited by 6 publications

References 43 publications

Post-covid-19 conditions in adults: systematic review and meta-analysis of health outcomes in controlled studies

Post-covid-19 conditions in adults: systematic review and meta-analysis of health outcomes in controlled studies

Covid longa, a pandemia que não terminou

Long COVID, the unending pandemic

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